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Year of Publication
2013

Abstract

Background: There is growing evidence that individuals with cognitive impairment and dementia require systematic assessment of needs for the selection of optimal treatments. Currently no valid instrument is applicable for illness-related need assessment in this growing population.; Method: The purpose of this study was to develop and validate a new instrument (“Bedürfnisinventar bei Gedächtnisstörungen”, BIG-65) that systematically assesses illness-related needs. The development was based on an adequate theoretical framework and standardised procedural guidelines and validated to an appropriate sample of individuals attending a Swiss memory clinic (n = 83).; Results: The BIG-65 provides a comprehensive range of biopsychosocial and environmental needs items and offers a dementia-friendly structure for the assessment of illness-related needs. The BIG-65 has high face validity and very high test-retest reliability (rtt = 0,916). On average 3.5 (SD = 3.7) unmet needs were assessed. Most frequently mentioned needs were: “forget less” (50%), “better concentration” (23.2%), “information on illness” (20.7%), “information on treatments” (17.1%), “less worry”, “less irritable”, “improve mood”, “improve orientation” (13.4% each). Needs profiles differed between patients with preclinical (subjective cognitive impairment, mild cognitive impairment) and clinical (dementia) diagnosis.; Discussion: The BIG-65 reliably assesses illness-related needs in individuals with moderate dementia. With decreasing cognitive functions or an MMSE <20 points, additional methods such as observation of the emotional expression may be applied. According to our results, individuals with cognitive impairment and dementia pursue individual strategies to stabilize their quality of life level. In addition to the assessment of objective illness symptoms the selection of optimal treatments may profit from a systematic needs assessment to optimally support patients in their individual quality of life strategies.;